Most recents (6)

IMCrit

@IM_Crit_

ICU Reminders:

RV-predominant cardiogenic shock

RV failure criteria:

RV pressure-volume loops:

Etiologies of RV failure:

Read 6 tweets

Sonu Abraham

@SonuAbrahamMD

#MiniTweetorial #Part1 on #RVFailure based on the @NEJM paper by @RyanTedfordMD @Brian_Houston12 !

A must read for all cardiology #ACCFIT fellows and @ACPIMPhysicians residents!
nejm.org/doi/pdf/10.105…

Let's begin !

Part 1 - Mechanisms of RV failure

Let's get started with a poll.

Do you know the various mechanisms of RV failure?

#1 #Pathophysiology

4 Mechanical Mechanisms➡️ >1 can co-exist and are interconnected :
✅Increased preload
✅Increased afterload
✅Decreased contractility
✅Decreased lucitropy

Read 9 tweets

Jinyang Yu

@dritsyk

A case of low ScvO2 (60%), high PvaCO2 (8.2 mmHg), fluid intolerance (CVP 11) and fluid responsiveness (PPV 17). What's the physiology and what to do?
#FOAMcc #Hemodynamics #ThePeoplesVentricle #FOAMed #Fluidtolerance #Cardiotwitter #CriticalCare

Post-cardiac surgery. MAP 70, HR 95, low dose pressor. High CVP (11 mmHg) with pathologic waveform of x < y-descent. PPV > 17 despite low Vt (< 6 mL/kg). Normal blood gasses, normal lactate.

#EchoFirst #POCUS #TEE: Mildly reduced LV function; #MAPSE 5.75 mm. EF visually 45-50%. Small EDV.

Read 11 tweets

Henry Han , MBBS, MD

@HanCardiomd

@ESC_Journals

This study shows that more than 1/3 of patients with new-onset #HeartFailure have #RVD

📌During up-titration of #GDMT, 49% show normalization of RV function

📌The improvement is associated with better outcomes, independent of LV function

onlinelibrary.wiley.com/doi/abs/10.100… @ESC_Journals

RV dysfunction as a predictor of clinical outcome in newly-Dx #HeartFailure

This analysis demonstrates #RVD at baseline and follow-up was associated with a higher risk of all-cause ☠️ [ HR- 1.66 (1.27-2.16) ] and HF 🏥 [ HR -2.20 (1.51-3.21) ]

onlinelibrary.wiley.com/doi/abs/10.100… #EJHF

Recovery of RV function is associated with better outcomes

This study also stated that improvement of TAPSE to ≥ 17mm during follow-up was associated with a reduction in all-cause ☠️ and #HeartFailure 🏥 (HR- 0.56[0.31-0.99] ), independent of
baseline TAPSE, age, sex, and LVEF

Read 4 tweets

Omid Kiamanesh, MD

@OKiamanesh